This week we dive in to the initial trauma assessment.
Core EM - Emergency Medicine Podcast Episode 133.0 – Initial Trauma Assessment
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Feb 19, 2018 Carl Prickshitis, a fourth-year medical student and trauma assessment blogger, shares invaluable insights on evaluating trauma efficiently. He emphasizes the importance of a systematic approach for minimizing missed injuries. The conversation covers pre-arrival information from EMS, the distinction between blunt and penetrating trauma, and the critical ABCDE primary survey method. Carl highlights effective airway assessments, circulation checks, and the role of the AMPLE mnemonic for focused history-taking. He also critiques the routine use of the digital rectal exam in trauma care.
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Episode notes
Do Elements In Parallel, Not Strict Order
- Although taught hierarchically, ABCDE elements must be assessed in parallel based on the patient's needs.
- Immediate bleeding may trump airway interventions in real-time decision making.
Assess Airway And Anticipate Transport Needs
- For airway, inspect for obstruction, listen for noisy breathing, and assess mental status and secretion clearance.
- Consider early intubation if the patient will go to CT, IR, or OR to avoid a crash airway in transit.
Evaluate Breathing And Ventilation
- For breathing, inspect, palpate, auscultate, check tracheal position and JVD, and get oxygenation and ventilation data.
- Use end-tidal CO2 to assess ventilation when available, not just pulse oximetry.